title: Spread of methicillin-resistant Staphylococcus aureus between the community and the hospitals in Asian countries: an ANSORP study.
abstract: OBJECTIVE
  Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in many Asian countries. Recent emergence of community-associated (CA) MRSA worldwide has added another serious concern to the epidemiology of S. aureus infections. To understand the changing epidemiology of S. aureus infections in Asian countries, we performed a prospective, multinational surveillance study with molecular typing analysis.
  
  
  METHODS
  We evaluated the prevalence of methicillin resistance in S. aureus isolates in CA and healthcare-associated (HA) infections, and performed molecular characterization and antimicrobial susceptibility tests of MRSA isolates.
  
  
  RESULTS
  MRSA accounted for 25.5% of CA S. aureus infections and 67.4% of HA infections. Predominant clones of CA-MRSA isolates were ST59-MRSA-SCCmec type IV-spa type t437, ST30-MRSA-SCCmec type IV-spa type t019 and ST72-MRSA-SCCmec type IV-spa type t324. Previously established nosocomial MRSA strains including sequence type (ST) 239 and ST5 clones were found among CA-MRSA isolates from patients without any risk factors for HA-MRSA infection. CA-MRSA clones such as ST59, ST30 and ST72 were also isolated from patients with HA infections.
  
  
  CONCLUSIONS
  Our findings confirmed that MRSA infections in the community have been increasing in Asian countries. Data also suggest that various MRSA clones have spread between the community and hospitals as well as between countries.
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. songjh@skku.edu
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
authors.forename: Doo Ryeon
authors.initials: DR
authors.lastname: Chung
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Ko
authors.forename: Cheol-In
authors.initials: CI
authors.lastname: Kang
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Joon-Sup
authors.initials: JS
authors.lastname: Yeom
authors.forename: Shin-Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Hyun-Ha
authors.initials: HH
authors.lastname: Chang
authors.forename: Yeon-Sook
authors.initials: YS
authors.lastname: Kim
authors.forename: Sook-In
authors.initials: SI
authors.lastname: Jung
authors.forename: Jun Seong
authors.initials: JS
authors.lastname: Son
authors.forename: Thomas Man-kit
authors.initials: TM
authors.lastname: So
authors.forename: M K
authors.initials: MK
authors.lastname: Lalitha
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Yang
authors.forename: Shao-Guang
authors.initials: SG
authors.lastname: Huang
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Quan
authors.initials: Q
authors.lastname: Lu
authors.forename: Celia C
authors.initials: CC
authors.lastname: Carlos
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Perera
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Jien-Wei
authors.initials: JW
authors.lastname: Liu
authors.forename: Anan
authors.initials: A
authors.lastname: Chongthaleong
authors.forename: Visanu
authors.initials: V
authors.lastname: Thamlikitkul
authors.forename: Pham Hung
authors.initials: PH
authors.lastname: Van
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005260:Female; D006801:Humans; D007223:Infant; D007391:International Cooperation; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D015995:Prevalence; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D055815:Young Adult